Rausch Osthoff Anne-Kathrin, Vliet Vlieland Theodora P M, Meichtry André, van Bodegom-Vos Leti, Topalidis Beatrice, Büchi Stefan, Nast Irina, Ciurea Adrian, Niedermann Karin
ZHAW, School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands.
BMC Rheumatol. 2022 Jan 17;6(1):12. doi: 10.1186/s41927-021-00233-z.
The Ankylosing Spondylitis Association of Switzerland (SVMB) aimed to implement physical activity recommendations (PAR) within their exercise groups (EGs). The PAR promote exercise in all fitness dimensions at the correct dose. To implement the PAR within EGs, they were translated into a new EG concept with five key activities: (a) training for supervising physiotherapists (PTs), (b) correctly dosed exercises in all fitness dimensions, (c) exercise counselling, (d) bi-annual fitness assessments, and (e) individual exercise training, in addition to EG. All these activities were realized in close coordination with SVMB management.
To analyse the implementation success by evaluating adherence/fidelity, feasibility, and satisfaction at the patient, PTs, and organisational level.
The five key activities of the new EG concept were developed, executed, and assessed after 6 months. The primary outcomes for implementation success were adherence of patients to the recommended exercise behaviour, self-reported by electronic diary; fidelity of PTs to the new concept, self-reported by diary; SVMB organisational changes. Secondary outcomes were feasibility and satisfaction with the new EG concept at all three levels. The tertiary outcome, to evaluate the effectiveness of PAR, was patient fitness, assessed through fitness assessments.
30 patients with axSpA (ten women, mean age 58 ± 9 years) and four PTs (three women, mean age 46 ± 9 years) participated. The patients' self-reporting of adherence to the PAR was insufficient (43%), possibly due to technical problems with the electronic dairy. The PTs' fidelity to the new EG concept was satisfactory. On all levels, the new concept was generally perceived as feasible and useful for supporting personalised exercise.The frequency of exercise counselling and the fitness assessments was found by patients and PTs to be too high and rigid. Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months.
The pilot implementation of PAR showed acceptance and satisfaction to be sufficient, thus confirming the need for evidence-based EGs, provided by a patient organisation in order to support active PA behaviour. However, adaptations are necessary to increase its feasibility for nationwide implementation.
SNCTP, SNCTP000002880. Registered 31 May 2018, https://www.kofam.ch/en/snctp-portal/search/0/study/42491 .
瑞士强直性脊柱炎协会（SVMB）旨在在其运动小组（EGs）中实施身体活动建议（PAR）。PAR以正确的剂量促进各个健身维度的运动。为了在EGs中实施PAR，将其转化为一个新的EG概念，包含五项关键活动：（a）为监督物理治疗师（PTs）提供培训，（b）在所有健身维度进行正确剂量的运动，（c）运动咨询，（d）每半年进行一次健身评估，以及（e）除EGs外的个人运动训练。所有这些活动均与SVMB管理层密切协调开展。
通过评估患者、PTs和组织层面的依从性/保真度、可行性和满意度来分析实施的成功情况。
新EG概念的五项关键活动制定、执行并在6个月后进行评估。实施成功的主要结果是患者通过电子日记自我报告对推荐运动行为的依从性；PTs通过日记自我报告对新概念的保真度；SVMB的组织变革。次要结果是所有三个层面上新EG概念的可行性和满意度。三级结果是通过健身评估来评估患者的健康状况，以评价PAR的有效性。
30例轴向性脊柱关节炎患者（10名女性，平均年龄58±9岁）和4名PTs（3名女性，平均年龄46±9岁）参与。患者对PAR依从性的自我报告不足（43%），可能是由于电子日记的技术问题。PTs对新EG概念的保真度令人满意。在所有层面上，新概念总体上被认为对于支持个性化运动是可行且有用的。患者和PTs发现运动咨询和健身评估的频率过高且过于死板。在6个月内，患者的心肺适能[效应量1.21（95%置信区间0.59，1.89）]和核心力量[效应量0.61（95%置信区间0.18，1.06）]有所改善。
PAR的试点实施显示出足够的接受度和满意度，从而证实了患者组织提供基于证据的EGs以支持积极的身体活动行为的必要性。然而，有必要进行调整以提高其在全国范围内实施的可行性。
SNCTP，SNCTP000002880。2018年5月31日注册，https://www.kofam.ch/en/snctp-portal/search/0/study/42491 。
